15 Year Results of Radical Prostectomy. A rather large study.

Interesting stats.

http://prostatecancerinfolink.net/2011/01/21/projection-of-15-year-prostate-cancer-specific-survival-after-radical-prostatectomy/

 

Thanks for posting this Chris. I wonder when will the Kattan nomogram will be updated.

Tks Chris, certainly worth a read, looking forward to the new nomograms.
..............Kev

Good information, Chris. I've always been at 99% on post-prostatectomy predictive nomograms. Now I'm at 99.9997%!

Post Edited (TimG) : 1/21/2011 8:06:35 PM (GMT-7)

As "good" as the news is for the G6 guys, the paper (not truly a study) does draw my attention to the 7% mortality rate projected. This does not surprise me but it clearly indicates that there is a significant increase in mortality rate when compared to ten year studies. I know it's improper to draw conclusions between two unconnected studies but there is a "factual" number used by the US Preventative Services Task Force and that is of all men diagnosed in the US about 3% will die from prostate cancer specific mortality. This paper suggests a significant increase in the mortality rate for those who survive long enough. This continues to strengthen my belief that we need longer study periods, preferably with Level 1 evidence.

Just an observation from someone who would like to live a lot longer than 15 years after RP...

Tony

Tony,
I think your numbers are a little off. If 3% of all deaths are caused by PC and 1 in 6 men (17%) are dxed with pc then the rate of death of thoses Dxed is 17%. So the rates projected are lower than the current rates. It's really not apples to apples because the study relates to surgically treated men. There are a lot of advanced PC cases that are Dxed that are never treated with a curative intent.
JT

An important message from this research, noted at the first post in the thread, is that the mortality from prostate cancer is significantly and dramatically different depending on the Gleason score and not the treatment. This is borne out over every research involving our disease. Thus the type of treatment selected is not the major factor in survival. The men who were G8-10 had the same treatment by the same doctors at the same hospital. They died in manifold more numbers. This was not because of the treatment but because of the underlying condition of the disease. Thus, where should the surgeon focus his efforts and where should he caution awareness, AS, monitoring and deliberation before treatment?

John,
The statistic that I am referring to is 3 in 100 men diagnosed with prostate cancer will die of PCSM.

Tony

One thing I have realized is that until the mortality rate is 0 I will constantly live in fear. Since nobody is ever able to tell you which side of the percentages you are on they might as well be 50/50 all the time. You don't know where you will fall. Every PSA test is a crap shoot. Even if the mortality rate was .5% after 15 years, you don't know if you will be one of those .5%  Even at .5% I would still worry about it, because the possibility is still there. We are all at risk of progression and death.

Also, I am not sure why we spend so much time trying to figure out what the exact number is when we don't know which side of the percentages we will be on. Someone said something pretty wise to me once, and that was. What if they could tell you exactly what your risk of mortality was in say 15 years and it was not 0. What would you do about it? Nothing. No matter what the risk is, there is nothing I can do about it. Not a thing. So it doesn't really matter if it's 3% or 7% or 50%.  The fact is there is a chance of death from it.

Again, even though I am a G6 "low risk" person, it doesn't mean that it is impossible that I won't ever have recurrence and die from PCa. Being "low risk" doesn't make having PCa any less stressful for me.

Post Edited (ChrisR) : 1/23/2011 7:33:06 AM (GMT-7)

ChrisR wrote: "One thing I have realized is that until the mortality rate is 0 I will constantly live in fear."

With respect, you can't possibly mean that. It's not as if you were immortal until you got prostate cancer and now you are going to die. We're all going to die, the only unknowns are how and when. And how we live our lives until we die.

Fear of what?

Death - why would death trigger fear? Regret or wistfulness, maybe, but fear? Our cells are programmed to die, it is a perfectly natural process. Were you afraid of being born?

The pain that often precedes death? Pain is also part of life, but in any event experiencing the pain of terminal cancer is voluntary, not required.

Constantly live in wonder, not fear. From wonder to wonder existence opens.

Zen9

Zen, very good post, well thought out answer, got my thumbs up on that one.

I think we are all afraid of dying or most of us would not be here. I am sure conversing about PCa is not anyones idea of fun. How many people joined this forum before they were dx. I bet none. Yea, I know I was going to die someday, but thought it was far off. Like most people I always thought that if I was careful and did not do anything really stupid there is no reason I would die young. That is until I met Mr. Cancer. It does not discriminate or care who or what age you are and anyone is capable of being struck down within 6 months in anytime in their life. I guess I fell victum to believing what I read in the press about things like "early dectection saves lives." And once you start reading about cancer and how many people never had a chance in heck no matter when they were dx. you become disillusioned. Especially, when we are constantly reminded that "screening for PCa" has not been proven to reduce mortality. It's not that I believed everything I read in the "paper", but I did think that the medical community was much more controlled about the information that they released to the public. And I believed they practiced a higher standard of professionalism. Yea, I was dupted.

Anyway, once of the things I have often thought about and even considered posting a topic here, was "What if they cured it tomorrow." My problem would not be solved. My life would not go back to the way it was before I was dx. I now worry about all the other cancers I could get and am constantly on high alert for any symptom. I realize that my problem is not PCa, it is dying. There are many coping stratagies developed for people who are dying. Unfortunately, they don't work for me. I lately have tried to turn my focus on dealing with my own death and not PCa, but it is a slow transition.

Like many people here, I have family I don't want my death to affect. Mainly my two young children. I am sort of comfortable that PCa won't get me before they are 18.  They are 5 and 9.

JohnT,

I have read the same thing that some studies have suggested that PCa people actually live longer then the general population because they become more health consicious. (sp) My PCa has caused me to clean up a few things in my blood work, that my PCP was not worried about. But, on the other had if you think about it dropping dead of a heart attach is really the way to go. Short amount of pain, no expensive hospital stay and you don't see it coming so you dont fret over it. Now I am taking care of my health so that won't happen so I can live longer and will probably die of another type of cancer instead. Because as we all know all of us are going to die of something.  Ironic isn't it?

Post Edited (ChrisR) : 1/23/2011 1:32:00 PM (GMT-7)

My reasoning, be it right or wrong is, sure I have PCa, and it is going somewhat in the wrong direction, latest 0.7 (up from 0.6) what is the use of worrying myself sick? I am 70, and too much stress and worry could manifest itself on my old body creating other problems for me, I am too busy living life, and have not got the time to waste, so I just enjoy my bowls, bike riding, fishing, family and granchildren, every now and then I go see my doctors, (6 monthly now) I get a bit anxious on the day, then put it out of my mind until next time, what will be will be, I have little or no control, so on with life!

Regards Mal.